Organization
JOHN KELLY, MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN J. KELLY MD (PHYSICIAN)
(517) 423-9300
Entity
Organization
Contact information
Practice address
115 S EVANS ST, TECUMSEH, MI 49286-1949
(517) 423-9300
(517) 423-9400
Mailing address
115 S EVANS ST, TECUMSEH, MI 49286-1949
(517) 423-9300
(517) 423-9400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
JK057968
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4970844
—
MI
Enumeration date
08/08/2007
Last updated
10/23/2014
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